白血病MICM分型的临床和实验研究

从形态学、免疫学、细胞遗传学及分子生物学特性（MICM）探讨白血病与临床疗效的关系，用骨髓细胞形态及组织化学染色分析作FAB分型诊断；流式细胞术（FCM）单克隆抗体直接免疫标记技术检测白血病细胞分化抗原，短期培养法与直接法G显带染色体组型分析。双色荧光原位杂交技术检测bcr/abl融合基因，结果：共检测出异常抗原表达急性白血病7例，47例FAB分型的急性髓细胞性白血病（AML）中5例伴有淋系相关抗原表达。15例FAB分型的急性淋巴细胞性白血病（ALL）中2例伴有髓系相关抗原表达，2例ALL呈T，B相关抗原混合表达。急性白血病中检出46，XY，t(8；21）等染色体畸变和bcr/abl融合基因，20例慢性髓细胞性白血病（CML）中Ph染色体阳性16例，7例伴有复杂染色体核型变异，5例检出bcr/abl融合基因，Ph染色体阴性的CML中，1例检测出bcr/abl融合基因，3例为夏杂染色体核型变异。伴有异常抗原表达的急性白血病化疗一疗程完全缓解（CR）率和二疗程总CR率均低于呈单系相关抗原表达的急性白血病（P＜0.05），伴复杂核型变异的CML急变时间短于Ph阳性的CML（P＜0.05），结论：白血病的MICM分型与临床疗效密切相关。

Study on MICM Classification on Clinical and Experiment of Leukemia

To explore the relations of Morphology Immnuophe-notype Cytogenetics Molecular biology(MICM) detection on diagnosis andtreat,emt of leukemia. Methods: 68 cases of leukemia patients had beenanalyzed by morphology(FAB). Immunohistochemistry(Flow Cytometry, FCM). chromosome G banding technique and dual-color fluorescence insitu hybridization (D-FISH).Technique:All patients were treated bychemotherapy. T test and X2 test of significance. Results: 7 cases have acute leukema aberration antigen expression. 5 out of 47 cases acutemyeliod leukemia patients accompany lymhocytic interrelated antigenexpression. 2/l5 cases acute lymphoid leukemia accompany myelocyteinterrelated antigen expression. 2 cases acute lmphoid leukemia are T cell and B cell interrelated antigen mingle expression. had been examined46,XY,t(8,2l) translocation of chromosome and bcr/abl fusion genes inthe acute leukemia patients. 16 out of 20 chronic myeloid leukemia patientshad philadelphia chromosome. 7 out of 20 patients had complicate karyotype. 5 out of 20 patients had bcr/abl fusion gene, l out of 4 patient had bcr/abl fusion gene that Ph chromosome showed negative in CML. 3/4 cases patients had complicate chromosome. The ratio of CR use l time chemotherapy and the total ratio of CR using 2 times chemotherapywith aberration antigen expression in acute leukemia was significantly lessthan those of the acute leukemia patient had single system antigenexpression(P<0 05). The time of CML-BC with complicate chromosome karyotype was significantly short than those of Ph showed negative in CML(P<0 05). Conclusion: The MICM classification is more accurate for diagnosis of leukemia and more significant in guiding the leukemiatreamen.